摘要
Background/Aims@#The aim of this study was to analyze the chronological changes in postoperative complications in surgical ulcerative colitis patients over the past decade in China and to investigate the potential parameters that contributed to the changes. @*Methods@#Ulcerative colitis patients who underwent surgery during 2008–2017 were retrospectively enrolled from 13 hospitals in China. Postoperative complications were compared among different operation years. Risk factors for complications were identified by logistic regression analysis. @*Results@#A total of 446 surgical ulcerative colitis patients were analyzed. Fewer short-term complications (24.8% vs. 41.0%, P=0.001) and more laparoscopic surgeries (66.4% vs. 25.0%, P<0.001) were found among patients who received surgery during 2014–2017 than 2008–2013. Logistic regression suggested that independent protective factors against short-term complications were a higher preoperative body mass index (odds ratio [OR], 0.870; 95% confidence interval [CI], 0.785–0.964; P=0.008), laparoscopic surgery (OR, 0.391; 95% CI, 0.217–0.705; P=0.002) and elective surgery (OR, 0.213; 95% CI, 0.067–0.675; P=0.009). The chronological decrease in short-term complications was associated with an increase in laparoscopic surgery. @*Conclusions@#Our data revealed a downward trend of short-term postoperative complications among surgical ulcerative colitis patients in China during the past decade, which may be due to the promotion of minimally invasive techniques among Chinese surgeons.
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The secondary damage after traumatic brain injury (TBI) involves a variety of pathological processes, and the inflammatory response in the nervous system is an important factor which affects nerve repair and regeneration. As the innate immune cell in the nervous system, microglia (MG) plays an important role in the entire neuroinflammatory environment by regulating the activation state of MG and changing the inflammatory response in the direction of promoting nerve repair and regeneration, which has great potential in treatment of TBI. This article reviews the inflammatory response of the nervous system after TBI and the reactivity of MG, as well as their significance in nerve repair and regeneration.
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Optic nerve gliomas (ONGs) are one type of optic pathway gliomas (OPGs), enjoying low incidence; they accounts for only 1% of intracranial tumors in children. They can either occur sporadically or complicate with neurofibromatosis type 1 (NF1). ONGs have unique clinical features, and the courses of diseases are variable and difficult to predict. Accurate diagnosis and reasonable treatment are controversial. This review focuses on the clinical features, diagnosis, and treatment of ONGs, in order to provide references for the treatment and follow-up research of ONGs.
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The primary fourth ventricle meningiomas (FVMs) are rare fourth intraventricular tumors. Meningiomas account for approximately 13%-20% of all intracranial tumors; 0.5%-3% of meningiomas locate in the ventricle, whereas only 5% of meningiomas locate in the ventricle occur in the fourth ventricle. To date, the report about the FVMs is less than 80 cases all over the world, and most of the literatures about this disease are case reports. The clinical manifestations, imaging features, intraoperative findings and prognoses are lack of comprehensive understanding. In this paper, based on the FVMs case reports and research progress in recent years, we aim to summarize the clinical characteristics and treatment of FVMs to provide a beneficial reference for the diagnoses and treatments of FVMs.
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As a kind of neuroectodermal tumor, ependymoma usually occurs in the spine in adults. However, 90% of children's ependymomas are intracranially located, and two thirds of them are located in the posterior fossa. The most commonly used clinical treatment for posterior fossa ependymomas is surgery combined with postoperative adjuvant therapy, but the high recurrence rate and poor prognosis suggest that it is urgent to explore more targeted and efficient treatment methods. In recent years, molecular biology technology has developed rapidly, the molecular biological characteristics of posterior fossa ependymomas are partially elucidated, and the molecular typing has been preliminarily determined and many potential therapeutic targets have been proposed. This review focuses on the role of histone H3 lysine 27 trimethylation in posterior fossa ependymoma and its potential therapeutic targets to provide references for treatments and follow-up researches of this disease.
摘要
Objective To investigate the proliferative capacity of neural stem cells (NSCs) in rat hippocampus after traumatic brain injury (TBI) and its relationship with Janus kinase 2/signaling and transcriptional activation factor 3 (JAK2/STAT3) signaling pathway activity.Methods A total of 108 SD rats were randomly divided into control group (36 rats) and TBI group (72 rats).The TBI model was constructed by PinPointTM Precision Cortical Impactor.At 1,3,7,14,21 and 28 days after injury,the brain tissues were taken for immunofluorescence staining to detect the proliferation of NSCs [5-bromodeoxyuridine (BrdU) +/stem cell key protein-2 (Sox2) +] in hippocampus,and phosphorylated JAK2 (p-JAK2) and phosphorylated STAT3 (p-STAT3) were detected by Western blot.The expression level of p-JAK2 and p-STAT3 as well as the changing trend were analyzed.On the basis of preliminary analysis of the proliferation of NSCs and the change of JAK2/STAT3 signaling pathway activity in hippocampus,another 24 SD rats were randomly divided into TBI + normal saline group and TBI +AG490 (JAK2 specific inhibitor) group,with 12 rats in each group.At 7 days after injury,the proliferation of NSCs in hippocampus was detected by immunofluorescence staining,and the expression levels of p-JAK2 and p-STAT3 were detected by Western blot,so as to further confirm the correlation between the proliferation ability of NSCs in hippocampus and JAK2/STAT3 signaling pathway.Results Compared with the control group,the number of NSCs in the hippocampus of the TBI group and the expression of p-JAK2 and p-STAT3 increased.And the most significant increase occurred at 7 days after injury [number of NSCs:31.2 ± 4.7 in the control group,111.4 ± 8.1 in the TBI group (P ＜ 0.01);p-JAK2:1.11 ± 0.09 in the control group,2.16 ± 1.01 in the TBI group (P ＜ 0.01);p-STAT3:1.05 ± 0.06 in the control group and 2.06 ± 0.09 in the TBI group (P ＜ 0.01)].The proliferation of NSCs in hippocampus of TBI group was consistent with the change of p-JAK2 and p-STAT3 expression.Seven days after injury,the expression levels of p-JAK2 and p-STAT3 and the proliferation ability of NSCs in the TBI + AG490 were significantly decreased [p-JAK2:2.18 ± 0.15 in the TBI + isotonic saline group,1.24 ±0.10 in the TBI + AG490 group (P ＜0.01);p-STAT3:2.21 ±0.12 in the TBI + isotonic saline group,1.25 ± 0.11 in the TBI + AG490 group (P ＜ 0.01);NSCs number:112.8 ± 8.6 in the TBI + isotonic saline group,75.5 ± 6.4 in the TBI + AG490 group (P ＜ 0.05)].Conclusions The proliferation of NSCs in hippocampus of rats increased after TBI,and the activity of JAK2/STAT3 signaling pathway also increased,following the same trend.JAK2 inhibitor AG490 can reduce the activity of JAK2/STAT3 signaling pathway and the proliferation of NSCs.This can provide reference for researches on TBI promoting nerve regeneration and function repair.
摘要
Patients with type Ⅱ neurofibromatosis often have multiple neurological tumors, including schwannoma, meningioma, astrocytoma and ependymoma, of which bilateral vestibular schwannoma is characteristic lesion. More than 90％of familial cases and 80％-85％of sporadic cases of type Ⅱ neurofibromatosis have been confirmed to have neurofibromatosis Ⅱ gene mutations in both tumor tissues and blood. This article reviews the relation of type Ⅱ neurofibromatosis with different types of tumors, and the incidence, natural history and latest treatment strategies of type Ⅱ neurofibromatosis, in order to provide new clues for diagnoses and treatments of patients with type Ⅱ neurofibromatosis complicated with multi-type tumors.
摘要
Medulloblastoma (MB) is one of the most common childhood malignant tumors in the central nervous system, which accounted for 15％-25％ of childhood intracranial tumors. The most common origin location of MB is at the middle line of the posterior cranial fossa. And, MB could usually invade into the cerebellar hemisphere, the fourth ventricle and the brainstem. According to the classification criterion of central nervous system tumor in 2016, MB was classified as class IV tumor. In recent years, with the development of histology and molecular biology techniques, classifications of MB were gradually refined, and MB of different types have different clinical outcomes. At the same time, the researchers and clinical workers are still continuously exploring new and effective treatment methods, making important breakthroughs. This article will systematically elaborate the progress of the clinical diagnoses and treatments, which might provide some useful theoretical references for diagnoses and treatments of childhood MB.
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Objective To explore the influence of exosome-derived miR-124 on the molecular expression related to axonal regeneration after mechanical damage to cortical neurons in mice,aiming to provide experimental data for intervention in neurogenesis after traumatic brain injury (TBI).Methods The plasmid loaded with miR-124 was used to transfect the HEK293 cell line.The transfection effect was identified by real time Polymerase Chain Reaction (qPCR).The exosomes were isolated from the supematant of cultured transfected HEK293 cell line by the SBI isolation kit.The isolated exosomes were identified by electron microscopy and Western blotting,and the involved miR-124 in the exosomes was identified by qPCR.After the cortical neurons were isolated from the pregnant mice (14-17-day old) and cultured for 7 days,they were divided into 4 groups:control,damage,damage + exosomes without miR-124 and damage + exosomes with miR-124.The Petri dishes were manually scratched with a 10 μL plastic stylet needle to construct a mechanical damage in vitro in the latter 3 groups.The isolated exosomes without or with miR-124 were added into the cultured medium for culture for 72 h in the latter 2 groups,respectively.The expression ofmiR-124,NRP-1,Tau and Gap-43 was measured by qPCR and Western blotting respectively.Results The exosomes containing miR-124 were successfully obtained by plasmid transfection and the SBI isolation kit.The expression levels of miR-124,NRP-1 and Gap-43 in the damage + exosomes with miR-124 group were elevated significantly greater than in the other 3 groups (P＜0.05).The expression levels ofmiR-124,NRP-1 and Gap-43 in the damage group and damage + exosomes without miR-124 group were elevated significantly greater than in control group (P＜0.05).Conclusions The exosomes may transmit miR-124 to the cortical neurons in mice after mechanical damage and increase the expression ofmiR-124,NRP-1 and Gap-43 in the cortical neurons in mice.
摘要
Objective To explore the effects of repressor element 1-silencing transcription factor (REST)/REST coinhibitory factor (CoREST) on axonal regeneration and repairmen of mouse cortical neurons after traumatic brain injury (TBI).Methods (1) The primary cortical neurons were obtained from fetal C57BL/6 mice;one,three,5,7,9,and 11 d after cultivation,miR-124 expression was detected by quantitative-(q-) PCR.(2) Neurons cultured for 5 d were divided into miR-124 mimics group,blank control group,and miR-124 inhibitor group,and miR-124 mimics,nonsense control sequences and miR-124 inhibitor were transfected,respectively;0,6,12,24,48,and 72 h after transfection,miR-124 expression was detected by q-PCR.(3) Neurons cultured for 7 d were divided into blank control group Ⅰ,oxygen glucose deprivation (OGD) model group,up-regulated miR-124+OGD model group,and down-regulated miR-124+OGD model group,and neurons in the later two groups were transfected with miR-124 mimics and miR-124 inhibitor;48 h after transfection,OGD models in the later three groups were prepared;0,6,12,24,48,and 72 h after OGD,miR-124 expression was detected by q-PCR;GAP-43,REST and CoREST expressions were detected by Western blotting 48 h after OGD;the REST and CoREST expressions were measured by immunofluorescent staining 48 h after OGD.Results (1) One,three,5,and 7 d after cultivation,miR-124 expression gradually increased,and 7,9,and 11 d after cultivation,miR-124 expression gradually decreased,with significant differences (P＜0.05).(2) Twenty-four and 48 h after transfection,miR-124 expression in the miR-124 inhibitor group was significantly lower than that in the blank control group (P＜0.05);12,24,48 and 72 h after transfection,miR-124 expression in the miR-124 mimics group was significantly higher than that in the blank control group (P＜0.05),and peak level was noted at 48 h.(3) The miR-124 expression in the OGD model group was significantly higher than that in the blank control group Ⅰ at 12,24,48 and 72 h after OGD (P＜0.05),and peak level was noted at 48 h;0,6,12,24,48,and 72 h after OGD,the miR-124 expression in the up-regulated miR-124+OGD model group was significantly higher than that in the blank control group Ⅰ (P＜0.05),and peak level was noted at 48 h;Western blotting indicated that GAP-43 and CoREST gradually increased,and REST gradually decreased in blank control group Ⅰ,OGD model group and down-regulated miR-124+OGD model group,with significant differences (P＜0.05);neurons in the up-regulated miR-124+OGD model group had significantly lower GAP-43 and CoREST expressions,and significantly higher REST expression than those in the OGD model group (P＜0.05);the results of immunofluorescence staining were consistent with those of Western blotting.Conclusion REST/CoREST,as a pair regulator,may play a key role in the repairment and regeneration of neuron axons after TBI.
摘要
Objective To explore the effect of exosome derived micro RNA (miR)-124 on activation status of microglia cells in injured brain tissues at acute phase of traumatic brain injury (TBI), and further provide theoretical references for intervention of neuroinflammation after TBI. Methods (1) In vitro cultured HEK293 cells were divided into miR-124 transfected group and control group, and miR-124 plasmids or Control siRNA by plasmid were transfected into the cells of the two groups;two-three weeks after isolation of monoclonal cell lines and two weeks after continuous culture, reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the miR-124 content in cells of the two groups; the exosomes were extracted from the supernatant of cells from the two groups using SBI kit, and the morphology of the exosomes was observed under electron microscope; the expression of CD63, a surface marker molecule, was detected by Western blotting; RT-PCR was used to determine the miR-124 content in the exosomes of the two groups. (2) A total of 60 healthy male rats were randomly divided into sham-operated group (n=12), TBI group (n=12) and TBI+Exo-124 group (n=24); TBI models were constructed by controlled cortical injury device, and Exo-124 (3×109 particles) was given into the TBI+Exo-124 group via tail intravenous injection and equivalent solvent was given to the sham-operated group and TBI group 24 h after TBI; 3 d after modeling, RT-PCR was used to detect the miR-124 expression in brain tissues of the injured areas of the three groups; flow cytometry (FCM) was used to detect the percentages of Iba-1+/CD32+ and Iba-1+/CD206+ microglial cells in brain tissues; enzyme-linked immunosorbent assay (ELISA) was used to detect the expressions of interleukin (IL)-1, IL-6, IL-4 and IL-10 in the brain tissues. Results (1) RT-PCR showed that the miR-124 expression in the miR-124 transfected group was statistically higher than that in the control group (P<0.05); electron microscopy showed spherical particles with diameter about 100 nm and obvious membrane structure; Western blotting showed that the expression level of CD63 in the miR-124 transfected group was significantly higher than that in the control group (P<0.05); RT-PCR showed that the miR-124 content in the miR-124 transfected group was significantly higher than that in the control group (P<0.05). (2) The miR-124 expression in injured brain tissues of TBI+Exo-124 group was statistically higher than that in TBI group and sham-operated group (P<0.05); as compared with those in the sham-operated group, the percentages of Iba-1+/CD32+ and Iba-1+/CD206+ microglial cells and the expressions of IL-1, IL-6, IL-4 and IL-10 in the brain tissues of TBI group were significantly increased (P<0.05); as compared with the TBI group, the TBI+Exo-124 group had significantly decreased percentage of Iba-1+/CD32+ microglial cells and significantly increased percentage of Iba-1+/CD206+ microglial cells, statistically decreased IL-1 and IL-6 expressions, and statistically increased IL-4 and IL-10 expressions (P<0.05). Conclusion Exosome-derived miR-124 promotes the polarization of microglia cells from M1 to M2 and reduces neuroinflammation at acute phase of TBI.
摘要
Objective To investigate the effects of sphingosine-1-phosphate receptor 1 (S1PR1) changes on the proliferation of endogenous neural stem cells (NSCs) in hippocampus after traumatic brain injury (TBI).Methods Rat TBI models were constructed by the means of controlled cortical injury.A total of 72 rats were included and randomly divided into four groups:sham,TBI,TBI + SEW (TBI + S1PR1 agonist SEW2871 intervention) and TBI + VPC group (TBI + S1PR1 antagonist VPC23019 intervention),with 18 rats per group.The TBI model was induced by a control cortical injury device.The injured rats in TBI + SEW group and TBI + VPC group were respectively administrated with S1PR1 agonist SEW2871 and antagonist VPC23019 at scheduled time points after TBI.Hippocampal S1PR1 expression was detected by Western-blotting and the proliferation of NSCs was assessed by double-labeled immunofluorescence staining at days 7,14 and 21 after injury.Results At days 7,14 and 21 after TBI,the hippocampal S1PR1 levels and NSCs proliferation amounts in sham,TBI,TBI + SEW and TBI + VPC groups were evidently different (P ＜ 0.05).In particular,the outstanding changes among the four groups above occurred at 7 d after injury were as following:S1PR1 expression in TBI group significantly increased by 1.56 times compared with that in sham group,and it was respectively upregulated by 66.67％ in TBI + SEW group and down-regulated by 20.29％ in TBI + VPC group (P ＜0.05).The nmmber of NSCs proliferation in TBI group was 2.08 times more than that in sham group,and it increased by 36.75％ in TBI + SEW group and reduced by 18.77％ in TBI + VPC group (P ＜ 0.05).Conclusion The expression of S1 PRI is closely associated with the proliferation of NSCs in hippocampus after TBI,indicating that S1PR1 activation may be an effective strategy to improve the posttraumatic neurogenesis.
摘要
Objective To investigate the effects of sphingosine-1-phosphate receptor 1 (S1PR1) changes on the proliferation of endogenous neural stem cells (NSCs) in hippocampus after traumatic brain injury (TBI).Methods Rat TBI models were constructed by the means of controlled cortical injury.A total of 72 rats were included and randomly divided into four groups:sham,TBI,TBI + SEW (TBI + S1PR1 agonist SEW2871 intervention) and TBI + VPC group (TBI + S1PR1 antagonist VPC23019 intervention),with 18 rats per group.The TBI model was induced by a control cortical injury device.The injured rats in TBI + SEW group and TBI + VPC group were respectively administrated with S1PR1 agonist SEW2871 and antagonist VPC23019 at scheduled time points after TBI.Hippocampal S1PR1 expression was detected by Western-blotting and the proliferation of NSCs was assessed by double-labeled immunofluorescence staining at days 7,14 and 21 after injury.Results At days 7,14 and 21 after TBI,the hippocampal S1PR1 levels and NSCs proliferation amounts in sham,TBI,TBI + SEW and TBI + VPC groups were evidently different (P ＜ 0.05).In particular,the outstanding changes among the four groups above occurred at 7 d after injury were as following:S1PR1 expression in TBI group significantly increased by 1.56 times compared with that in sham group,and it was respectively upregulated by 66.67％ in TBI + SEW group and down-regulated by 20.29％ in TBI + VPC group (P ＜0.05).The nmmber of NSCs proliferation in TBI group was 2.08 times more than that in sham group,and it increased by 36.75％ in TBI + SEW group and reduced by 18.77％ in TBI + VPC group (P ＜ 0.05).Conclusion The expression of S1 PRI is closely associated with the proliferation of NSCs in hippocampus after TBI,indicating that S1PR1 activation may be an effective strategy to improve the posttraumatic neurogenesis.
摘要
<p><b>OBJECTIVE</b>To demonstrate the clinical applicability of three-dimensional CT angiography by evaluating the anatomic features and variation of inferior mesenteric artery(IMA) and left colic artery(LCA) in order to provide reference to vessel ligation strategy in laparoscopic rectal cancer surgery.</p><p><b>METHODS</b>Clinical and image data of 123 patients receiving abdominal multislice CT at The Sixth Affiliated Hospital from 2014 to 2015 were retrospectively analyzed. The images were 3D-reconstructed with computer 3D CT angiography and arterial enhancement phase images were chosen for analysis. Linear distances from IMA root to abdominal aortic bifurcation and from LCA at IMA root level to IMA root were measured. Branch types of IMA, coursing pattern of LCA, and association between LCA and inferior mesenteric vein (IMV) site were summarized.</p><p><b>RESULTS</b>Of 123 cases, 80 were males and 43 were females, mean age was (46.8±16.6) years, body weight was (57.7±10.4) kg, and BMI was (21.3±3.6) kg/m. The average distance from IMA root to abdominal aortic bifurcation was (42.5±7.9) mm, and this distance was closely associated with body weight (OR=4.771, 95%CI: 1.398 to 16.283, P=0.013). Longer distance tended to appear in the heavier patients. LCA and sigmoid artery (SA) originating from same single IMA was found in 61(49.6%) cases; LCA and SA forking at same point in 35(28.5%) cases; LCA and SA coursing together and forking afterwards in 24(19.5%) cases, and LCA disappearing in 3(2.4%) cases. In 71(57.7%) patients, LCA ascended medial to the lateral border of left kidney, while in 16(13.0%) patients, LCA arranged below the inferior border of left kidney. When the LCA site was higher and the distance from LCA to IMA root was closer [distance from LCA to IMA root level was (24.2±9.9) mm, (30.0±15.2) mm and (66.6±12.3) mm, F=83.2, P<0.001]. At the level of IMA root, LCA located medial to IMV in 21(17.1%) cases, located just lateral to IMV in 54(43.9%) cases, and located lateral and ascended far away from IMV in 48(39.0%) cases.</p><p><b>CONCLUSION</b>3D-CT angiography is non-invasive, efficient and accurate in evaluating coursing features and variation of IMA and its branches, which can provide important reference to the surgeons, promising laparoscopic surgery smooth and safe.</p>
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Objective To observe the expression changes of microRNA-124(miRNA-124) following traumatic brain injury (TBI) in mice and investigate the correlation of miRNA-124 with neural axon regeneration.Methods Ninety-one C57BL/6 mice were assigned into TBI group (n =63) and control group (n =28) according to the random number table.Mice in TBI group were subjected to controlled cortical impact and euthanized at 12 hours and 1,3,7,14,21,28 days postinjury for the collection of brain tissue in the trauma zone.Mice in control group underwent craniectomy only.Trauma zone observation was done using the HE staining.Expression of miRNA-124 was detected using the real-time PCR.Levels of Nrp-1,Gap-43 and Tau were detected using the Western blot and immunohistochemical staining.Results After injtury,study of mice behavior and HE staining indicated the establishment of experimental model was successful.Expression of miRNA-124 reached the peak at 3 days postinjury (3.80 ± 0.22),expression of Nrp-1 reached the peak at 7 days postinjury (2.006 ±0.179),expression of Tau reached the peak at 14 days postinjury (2.063 ±0.172),and expression of Gap-43 sustained high level since 12 hours after injury(1.355 ± 0.093) (P ＜ 0.05).Count of axon marker positive cells in TBI group was the lowest at 1 day postinjury due to the direct damage and edema,and then slowly recovered.There was no significant difference in the count of axon marker positive cells between the two groups at 14,21 and 28 days postinjury (P ＞ 0.05),but the morphology in TBI group changed obviously.Although the positive cells of axon marker decreased at 1 day postinjury,expressions of miRNA-124,Nrp-1,Tau and Gap-43 in TBI group were significantly increased compared to the detections in control group (P ＜ 0.05).Conclusion Increased expression of miRNA-124 in trauma zone may closely related to axon regeneration after TBI in mice.
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<p><b>OBJECTIVE</b>To investigate the risk factors of early surgical intervention in Crohn's disease (CD) patients with spontaneous intra-abdominal abscess.</p><p><b>METHODS</b>Clinical data of 94 CD patients with spontaneous intra-abdominal abscess admitted to The Sixth Affiliated Hospital of Sun Yat-sen University between May 2008 and Dec 2015 were analyzed retrospectively. Univariate and multivariate analysis were applied to evaluate the early surgery risk of CD patients with spontaneous intra-abdominal abscess using logistic regression model.</p><p><b>RESULTS</b>A total of 94 eligible patients were identified from our registry, including 70 males and 24 females. The mean age at the diagnosis of CD and at development of abscess was 28.4 years and 30.4 years old, respectively. The median duration of CD between the diagnosis and development of an abscess was 3 years. According to the Montreal classification, L3 (ileocolonic) was the most common disease location (81.9%) in these patients. Most of the patients(76.6%) developed a single abscess, while multiple abscesses were detected in 22 patients(23.4%). Forty-four patients(46.8%) underwent surgery within 60 days after hospitalization due to spontaneous intra-abdominal abscess complicating CD. Multivariate logistic regression analysis revealed that history of abdominal surgery(OR=3.23, 95%CI:1.12 to 9.31, P=0.030), concomitant intestinal stenosis (OR=3.52, 95%CI:1.26 to 9.85, P=0.017) and concomitant intestinal fistula (OR=4.31, 95%CI:1.25 to 14.80, P=0.020) were the independent risk factors of early surgical intervention, while enteral nutrition (OR=0.18, 95%CI:0.05 to 0.62, P=0.007) was the independent protective factor.</p><p><b>CONCLUSIONS</b>Nearly half of CD patients with spontaneous intra-abdominal abscess will undergo early surgical intervention. Patients with history of abdominal surgery, concomitant intestinal stenosis and concomitant intestinal fistula have higher risk of early surgical intervention, and appropriate application of enteral nutrition may reduce the risk.</p>
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<p><b>OBJECTIVE</b>To determine the indications of colonoscopic screening for Crohn's disease in patients with fistula-in-ano.</p><p><b>METHODS</b>Clinical data of 302 patients with perianal fistula who received colonoscopy examination from January 2010 to December 2013 in the Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University were analyzed retrospectively. Parameters for differentiating perianal Crohn's disease from nonspecific fistulae were screened by logistic regression analysis. A regression mathematical model was established for the prediction of perianal Crohn's disease.</p><p><b>RESULTS</b>A total of 302 patients received colonoscopy examination, and Crohn's disease was found in 16 patients (CD group). Results of univariate analysis on 26 parameters of clinical manifestation, laboratory and radiological examination revealed that differences in 11 clinical parameters between the CD group and non-CD group were statistically significant(all P<0.05), including age, BMI, abdominal pain, non-specific symptoms, multiple fistula, complex anal fistula, neutrophil count, platelet count, activated partial thromboplastin time, hemoglobin concentration and serum albumin concentration. Multivariate analysis revealed that age≤40 years (OR=14.464, 95% CI: 1.143-183.053, P=0.039), BMI<24.0 kg/m(OR=8.220, 95% CI:1.005-67.200, P=0.049), abdominal pain (OR=13.148, 95% CI: 1.110-155.774, P=0.041), complex anal fistula (OR=7.056, 95% CI:1.166-42.688, P=0.033) and elevated platelet count (OR=1.012, 95% CI: 1.004-1.0194, P=0.003) were independent risk factors for discovery of Crohn's disease by colonoscopy. Area under the ROC curve of the regression mathematical model based on factors mentioned above was 0.921, indicating that the model was highly predictive. The sensitivity and specificity of this model was 81.3% and 86.7% respectively when the optimal diagnostic cut-off point was established at 0.856.</p><p><b>CONCLUSIONS</b>Parameters that predict Crohn's disease in patients with perianal fistula include age, BMI, abdominal pain, classification of fistula and platelet count. Colonoscopy is recommended for patients at high risk.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Abdominal Pain , Age Factors , Body Mass Index , Colonoscopy , Crohn Disease , Blood , Diagnosis , Epidemiology , Leukocyte Count , Multivariate Analysis , Neutrophils , Partial Thromboplastin Time , Platelet Count , ROC Curve , Rectal Fistula , Blood , Retrospective Studies , Risk Factors , Sensitivity and Specificity摘要
Inflammatory bowel disease (IBD) is a bowel disease with uncontrolled inflammation and unknown etiology.With the recent expert consensus,multidisciplinary collaborative groups focusing on IBD have been gradually built in China,and IBD is not only an internal medical disease anymore.Furthermore,the therapeutic effect of IBD has also been greatly improved,but it is still not satisfactory.Precision therapy is the future direction of treatment for IBD,meanwhile,stem cell therapy and fecal transplantation also provide the new choices for refractory IBD.
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<p><b>OBJECTIVE</b>To explore the efficacy of adipose-derived mesenchymal stem cells (ADMSCs) in a murine model of inflammatory bowel disease, and its potential mechanism.</p><p><b>METHODS</b>Murine colitis mouse model of Crohn's disease(CD) was created by trinitrobenzene sulfonic acid(TNBS)-induced colitis. Seventy-five 6-8 weeks female BALB/c mice were randomly divided into 3 groups: control group, TNBS group and ADMSC group. To verify the therapeutic effect of ADMSC, real-time PCR and immunohistochemical staining were performed to measure inflammatory cytokines levels in colon tissues. The 10-day survival statuses were recorded after the infusion of ADMSCs.</p><p><b>RESULTS</b>Intraperitoneal injection of ADMSCs alleviated the clinical and histopathologic severity of intestinal inflammation, and increased survival(60% vs. 30%, P<0.05) in the TNBS-induced mouse model of CD. Compared with TNBS group, proinflammatory cytokines, including TNF-α, IL-12 and VEGF of ADMSC group were significantly reduced, with significant increase of IL-10 expression.</p><p><b>CONCLUSION</b>ADMSCs can effectively repair the injury of colonitis through down-regulation of proinflammatory cytokines TNF-α, IL-12 and VEGF expression, and up-regulation of anti-inflammatory cytokine IL-10 expression, which may be a potential new alternative of cell-based therapy for CD.</p>
Subject(s)
Animals , Female , Mice , Adipocytes , Colitis , Crohn Disease , Cytokines , Disease Models, Animal , Down-Regulation , Inflammatory Bowel Diseases , Mesenchymal Stem Cells , Mice, Inbred BALB C , Trinitrobenzenesulfonic Acid , Up-Regulation摘要
Objective To investigate the expression and prognostic significance of Interleukin-36α (IL-36α) in colorectal cancer.Methods The expression of IL-36α was tested by immunohistochemical staining in 329 cases of colorectal cancer.According to the intensity and the proportion of positive tumor cells,all the patients were divided into IL-36α low and high expression groups.The clinicopathological factors and prognosis of patients between IL-36α low high expression groups were compared.Results Significant differences were observed in the number of patients in tumor differentiation and pM classification between patients in the IL-36α low and high expression groups (P ＜ 0.05).The 5-year overall and tumorfree survival rates of patients were 79.3％ and 77.2％ in IL-36α low expression group,and 66.3％ and 65.3％ in IL-36α high expression group (P ＜0.05).COX proportional hazard regression model revealed that high expression of IL-36α was associated with short overall survival time and tumor-free survival time of colorectal cancer patients (P ＜ 0.05).Multivariate analysis identified IL-36α expression in colorectal cancer as an independent prognosticator (P ＜ 0.05).Conclusions High expression of IL-36α was correlated with tumor differentiation and pM classification of colorectal cancers,and it is an independent predictor of poor survival for patients with colorectal cancer.